{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T06:59:38Z","timestamp":1785394778312,"version":"3.55.0"},"reference-count":23,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"the 2024 Hospital-Level Educational and Teaching Reform Research Project of the First Affiliated Hospital of Harbin Medical University","award":["YDYYJX202407"],"award-info":[{"award-number":["YDYYJX202407"]}]},{"name":"Heilongjiang Province Young Science and Technology Talent Lifting Project","award":["2024QNTJ013"],"award-info":[{"award-number":["2024QNTJ013"]}]},{"name":"the Excellent Young Medical Talents Supporting Project in the First Affiliated Hospital of Harbin Medical University","award":["2024YQ15"],"award-info":[{"award-number":["2024YQ15"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Education and Curricular Development"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Integrating theoretical instruction with the development of clinical reasoning and practical competence remains a challenge in internal medicine education. This study evaluated an integrated teaching model designed to facilitate the transfer of classroom learning to clinical practice in undergraduate medical education.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Eighty undergraduate medical students were randomly assigned to an RQMN group receiving the RQMN integrated teaching model\u2014a structured sequence of role playing, question raising, making diagnostic and therapeutic plans, and novice clinical apprenticeship through supervised clerkship\u2014or a control group receiving conventional instruction. Outcomes were assessed immediately after completion of the course and clinical clerkship using a comprehensive clinical competence evaluation and a structured questionnaire on learning experience and teaching quality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      No significant difference was observed in theoretical examination scores between the groups. However, the RQMN group performed significantly better in several practice-oriented domains, including medical history taking, physical examination, communication skills, clinical judgment, and medical record writing (all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05). Questionnaire results also showed greater improvements in learning interest, self-directed learning, teamwork, clinical reasoning, and practical skills among students in the RQMN group (all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05), without a marked increase in perceived learning-related stress. Overall satisfaction with teaching quality and learning experience was also higher in the RQMN group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The RQMN integrated teaching model was associated with short-term improvements in selected clinical skills and self-reported learning experiences immediately after course completion, while theoretical examination performance was maintained. Further studies with delayed follow-up are needed to determine whether these gains are retained and transferred to later clinical performance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23821205261474113","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T21:11:05Z","timestamp":1785186665000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["An RQMN Integrated Teaching Model to Improve Clinical Competence in Undergraduate Internal Medicine Education: A Randomized Controlled Study"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8317-5394","authenticated-orcid":false,"given":"Haoruo","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Cardiology, First Affiliated Hospital of Harbin Medical University"},{"name":"Department of Endocrinology, Second Affiliated Hospital of Nanchang University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7709-4519","authenticated-orcid":false,"given":"Liqi","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Second Affiliated Hospital of Nanchang University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4451-4841","authenticated-orcid":false,"given":"Rui","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Cardiology, First Affiliated Hospital of Harbin Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6605-9048","authenticated-orcid":false,"given":"Chunlin","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Cardiology, First Affiliated Hospital of Harbin Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3579-5004","authenticated-orcid":false,"given":"Jiaoyue","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Cardiology, First Affiliated Hospital of Harbin Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5328-7023","authenticated-orcid":false,"given":"Xindan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, First Affiliated Hospital of Harbin Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8637-8714","authenticated-orcid":false,"given":"Siting","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Cardiology, First Affiliated Hospital of Harbin Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.3946\/kjme.2025.333"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-021-06916-0"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.3946\/kjme.2024.292"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0309606"},{"key":"e_1_3_6_6_2","doi-asserted-by":"crossref","unstructured":"Shi X-Y Yin Q Wang Q-W et al. Is the flipped classroom more effective than the traditional classroom in clinical medical education: a systematic review and meta-analysis. 2025;Volume 9-2024.","DOI":"10.3389\/feduc.2024.1485540"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-022-03154-8"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.3109\/0142159X.2012.680939"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1080\/01421590500046924"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.3109\/0142159X.2012.650741"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-025-08323-z"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1152\/advan.00232.2023"},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-024-05973-3"},{"key":"e_1_3_6_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/medu.12839"},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.3109\/0142159X.2010.501190"},{"key":"e_1_3_6_16_2","first-page":"12","volume-title":"mind maps, reflective journals, and peer simulations for advanced health assessment","author":"Cheng J","year":"2025","unstructured":"Cheng J, Wu Y, Huang L, Wu Y, Guan Y. Integrating Kolb\u2019s experiential learning theory into nursing education: a four-stage intervention with case analysis. In: mind maps, reflective journals, and peer simulations for advanced health assessment; 2025:12-2025."},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-024-06184-6"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsurg.2024.06.006"},{"key":"e_1_3_6_19_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-023-04134-2"},{"key":"e_1_3_6_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nedt.2025.106817"},{"key":"e_1_3_6_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0b013e318217e119"},{"key":"e_1_3_6_22_2","doi-asserted-by":"publisher","DOI":"10.5334\/pme.1595"},{"key":"e_1_3_6_23_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-020-02287-y"},{"key":"e_1_3_6_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/jgf2.70072"}],"container-title":["Journal of Medical Education and Curricular Development"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23821205261474113","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/23821205261474113","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23821205261474113","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T06:17:29Z","timestamp":1785392249000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/23821205261474113"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":23,"alternative-id":["10.1177\/23821205261474113"],"URL":"https:\/\/doi.org\/10.1177\/23821205261474113","relation":{},"ISSN":["2382-1205","2382-1205"],"issn-type":[{"value":"2382-1205","type":"print"},{"value":"2382-1205","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"article-number":"23821205261474113"}}